Objective To explore the feasibility of the CT image reconstruction of laryngeal cartilage and hyoid bone in adult age estimation using data mining methods. Methods The neck thin slice CT scans of 413 individuals aged 18 to <80 years were collected and divided into test set and train set, randomly. According to grading methods such as TURK et al., all samples were graded comprehensively. The process of thyroid cartilage ossification was divided into 6 stages, the process of cricoid cartilage ossification was divided into 5 stages, and the synosteosis between the greater horn of hyoid and hyoid body was divided into 3 stages. Multiple linear regression model, support vector regression model, and Bayesian ridge regression model were developed for adult age estimation by scikit-learn 0.17 machine learning kit （Python language）. Leave-one-out cross-validation and the test set were used to further evaluate performance of the models. Results All indicators were moderately or poorly associated with age. The model with the highest accuracy in male age estimation was the support vector regression model, with a mean absolute error of 8.67 years, much higher than the other two models. The model with the highest accuracy in female adult age estimation was the support vector regression model, with a mean absolute error of 12.69 years, but its accuracy differences with the other two models had no statistical significance. Conclusion Data mining technology can improve the accuracy of adult age estimation, but the accuracy of adult age estimation based on laryngeal cartilage and hyoid bone is still not satisfactory, so it should be combined with other indicators in practice.
Adolescent ; Adult ; Bayes Theorem ; Child ; Data Mining ; Female ; Humans ; Hyoid Bone/diagnostic imaging* ; Image Processing, Computer-Assisted ; Laryngeal Cartilages/diagnostic imaging* ; Male ; Tomography, X-Ray Computed

hyoid bone (PHy), distance from the mandibular plane to the hyoid bone (MP-Hy), and distance from the posterior nasal spine to the mandibular plane (P-MP). Ratios for each segment were also determined.RESULTS: Subjects with OSAS had longer P-Hy and MP-Hy than the control group. In particular, MP-Hy was significantly longer in the moderate-severe group than the other groups. In the OSAS group, there were significant correlations between MP-Hy, Ratio1, Ratio3 and m-Cor, s-Cor.CONCLUSION: Length of upper airway and ratio parameters of cephalometry may be more useful indices in moderate-severe OSA than absolute distance parameters, and Ratio1 may be valuable for prediction of activating HPA axis.]]>
Airway Resistance ; Cephalometry ; Child ; Humans ; Hydrocortisone ; Hyoid Bone ; Methods ; Sleep Apnea, Obstructive ; Spine

The Stafne bone cavity (SBC), also called the static bone cavity, salivary inclusion cyst, latent cyst, and lingual bone defect is an asymptomatic bony defect that is commonly located inferior to the mandibular canal and slightly above the inferior border of the mandible. It is rare to see the actual bony defect in the cadaver because of its relatively low incidence of 0.1% to 6.06%. We report a unilateral SBC found in a 76-year-old at death male Caucasian cadaver and involving the right mandible. The SBC was oval in shape with a smooth surface and measured 10.8×6.0 mm. The SBC was continuous with the right mylohyoid groove. Since actual photographs of the SBC are lacking in the literature, this report might provide additional insight for better understanding the SBC.
Aged ; Cadaver ; Humans ; Hyoid Bone ; Incidence ; Male ; Mandible

The aim of this study was to analyze the changes and improvements in symptoms of sleep-disordered breathing (SDB) using semi-rapid maxillary expansion (SRME) in children with narrow maxilla and SDB symptoms. Subjects were 15 patients with sleep disorder (apnea-hypopnea index, AHI ≥ 1) and narrow maxillary arch between 7 and 9 years of age. Before the SRME was applied, all subjects underwent pediatric sleep questionnaires (PSQ), lateral cephalometry, and portable sleep monitoring before expansion (T0). All subjects were treated with SRME for 2 months, followed by maintenance for the next 3 months. All subjects had undergone PSQ, lateral cephalometry, and portable sleep monitoring after expansion (T1). Adenoidal-nasopharyngeal ratio (ANR), upper airway width and hyoid bone position were measured by lateral cephalometry. The data before and after SRME were statistically analyzed with frequency analysis and Wilcoxon signed rank test. As reported by PSQ, the total PSQ scale was declined significantly from 0.45 (T0) to 0.18 (T1) (p = 0.001). Particularly, snoring, breathing, and inattention hyperactivity were significantly improved (p = 0.001). ANR significantly decreased from 0.63 (T0) to 0.51 (T1) (p = 0.003). After maxillary expansion, only palatopharyngeal airway width was significantly increased (p = 0.035). There was no statistically significant difference in position of hyoid bone after expansion (p = 0.333). From analysis of portable sleep monitoring, changes in sleep characteristics showed a statistically significant decrease in AHI and ODI, and the lowest oxygen desaturation was significantly increased after SRME (p = 0.001, 0.004, 0.023).In conclusion, early diagnosis with questionnaires and portable sleep monitoring is important. Treatment using SRME will improve breathing of children with SDB.
Cephalometry ; Child ; Diagnosis ; Early Diagnosis ; Humans ; Hyoid Bone ; Maxilla ; Oxygen ; Palatal Expansion Technique ; Polysomnography ; Respiration ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Snoring

We present the case of a 23-year-old man who suddenly collapsed during a physical altercation with his friends while in a drunken state. The post-mortem computed tomography (CT) with angiography revealed acute basal subarachnoid hemorrhage with rupture of the left middle cerebral artery. On autopsy, the head, face, mandible and neck showed multifocal hemorrhages with fracture of the hyoid bone, and the pathologic findings of the brain was consistent with CT findings. However, the vascular rupture site was not observed macroscopically. On histologic examination, a microscopic focal rupture was identified at the proximal portion of the middle cerebral artery, and possibility of arteriopathy was considered. This case illustrates that other parts of intracerebral arteries (other than the vertebral arteries) can be the culprit of rupture in the case of traumatic basal subarachnoid hemorrhage, and the post-mortem angiographic findings can be helpful in targeting the site of vascular injury. Furthermore, meticulous sampling of intracranial vessels could help find the vascular rupture site and identify any histologic findings suspicious of arteriopathy. Therefore, we suggest that post-mortem angiography can be an effective and adjunctive tool for a tailored approach in finding the vascular injury, and that histologic examination of both the intracranial and extracranial arteries be important to medicolegally ensure the death of traumatic basal subarachnoid hemorrhage and to examine presence of arteriopathy as a predisposing factor.
Angiography ; Arteries ; Autopsy ; Brain ; Causality ; Forensic Pathology ; Friends ; Head ; Hemorrhage ; Humans ; Hyoid Bone ; Mandible ; Middle Cerebral Artery ; Neck ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic ; Vascular System Injuries ; Young Adult

Hanging is the most common method of suicide in Malaysia. However, hanging in combination with suicidal ligature strangulation is uncommon. The victim is a 31-year-old man, with no previous medical or psychiatric disorders. He accomplished self-strangulation using a shoelace and hanging himself with a High-Definition Multimedia Interface cable. Three loops of a shoelace ligature were present around the neck. A single knot was present on the front, and a double knot at the back of the neck. Internal examination of the neck revealed small bilateral hemorrhages of the sternocleidomastoid muscles. No laryngeal cartilage or hyoid bone fractures were observed. No other evidence of injury was noted other than moderate pulmonary edema. The post-mortem toxicology results were negative. The cause of death was ascertained as neck compression due to ligatures. Scene assessment and post-mortem findings concur with suicide. This report describes an unusual case of suicidal ligature strangulation, in combination with hanging using two different ligatures.
Adult ; Cause of Death ; Hemorrhage ; Humans ; Hyoid Bone ; Laryngeal Cartilages ; Ligation ; Malaysia ; Methods ; Multimedia ; Muscles ; Neck ; Pulmonary Edema ; Suicide ; Toxicology

OBJECTIVE: To investigate the differences in hyolaryngeal kinematics at rest and during swallowing in the upright sitting (UP) and the lateral decubitus (LD) postures in healthy adults, and delineating any potential advantages of swallowing while in the LD posture. METHODS: Swallowing was videofluoroscopically evaluated in 20 healthy volunteers in UP and LD postures, based on the movements of hyoid bone, vocal folds, and the bolus head. Parameters included the Penetration-Aspiration Scale (PAS), horizontal and vertical displacement, horizontal and vertical initial position, horizontal and vertical peak position, time to peak position of the hyoid bone and vocal folds, and pharyngeal transit time (PTT). RESULTS: Nine participants were rated PAS 2 in the UP and 1 was rated PAS 2 in the LD (p=0.003) at least 1 out of 3 swallows each posture. The hyoid and vocal folds showed more anterior and superior peak and initial positions in the LD. In addition, swallowing resulted in greater vertical and smaller horizontal displacement of the hyoid in LD posture compared with UP. Time to peak position of the hyoid was shorter in LD. The maximal vertical and horizontal displacement of the vocal folds, and PTT were comparable between postures. CONCLUSION: The results showed that the peak and initial positions of the hyoid and larynx and the pattern of hyoid movement varied significantly depending on the body postures. This study suggests that the LD posture was one of the safe feeding postures without any increased risk compared with UP posture.
Adult ; Biomechanical Phenomena ; Deglutition Disorders ; Deglutition* ; Head ; Healthy Volunteers ; Humans ; Hyoid Bone ; Larynx ; Posture* ; Swallows ; Vocal Cords

This study recruited two men with dysphagia after stroke, aged 57 and 62 years. They had difficulty using both hands properly due to paralysis of the left upper extremity and rheumatoid arthritis of the right hand in patient 1 and paralysis of both upper extremities in patient 2. This study examined the effects of 4 weeks of hand-free chin-tuck-resistance exercise on the hyoid movement and aspiration. The exercises involved isotonic and isometric parts. In isometric CTAR, the patients were asked to chin tuck against the device 3 times for 60 s each with no repetition. In isotonic CTAR, the patient performed 30 consecutive repetitions by strongly pressing against the resistance device and then releasing it. Based on a video fluoroscopic swallowing study, the degree of aspiration was measured using the Penetration-Aspiration Scale (PAS) and two-dimensional motion analysis of the hyoid bone. Post-intervention, the hyoid movements in both patients improved by 0.16 and 0.22 cm (anterior movement), and 0.26 and 0.28 cm (superior movement), and the PAS scores decreased by 2 and 2 points, respectively. This study confirms that hands-free chin-tuck resistance exercise is applicable and helpful for improving the hyoid movement and reducing aspiration in patients with dysphagia after stroke. Therefore, this exercise can be introduced as an intervention for improving the swallowing function in patients with dysphagia who have difficulty using both hands.
Arthritis, Rheumatoid ; Chin ; Deglutition ; Deglutition Disorders* ; Exercise ; Hand ; Humans ; Hyoid Bone* ; Male ; Paralysis ; Stroke* ; Upper Extremity

OBJECTIVE: This study evaluated the temporal variables of hyolaryngeal movements during normal swallowing using kinematic analysis of the video fluoroscopic swallowing study (VFSS) to present the normal cut-off values of those variables. METHODS: Seventy-five healthy volunteers (17 men, 58 women) without swallowing dysfunctions were recruited to examine the swallowing of 2-ml diluted barium by a VFSS. Kinematic analysis was conducted by digitization of video files for movements of hyolaryngeal structures, including the vocal cords, hyoid bone, and epiglottis during normal swallowing. The time points and duration of hyolaryngeal movements were measured. The time points were the start point, maximal point, and the end point of the LE (Laryngeal Elevation), HE (Hyoid Excursion), and EF (Epiglottic Folding). The durations of LE, HE, and EF were obtained by subtracting the time of the start point from the time of the maximal point. The onset time of LE was defined as the reference time point (0 sec). The upper and lower limits of the 95% confidence interval were adopted as the normal cut-off values for the temporal variables of hyolaryngeal movements after transformation to a normal distribution. If a transformation formula to a normal distribution was not found in a variable, the values of the 2.5–97.5 percentile were adopted. RESULTS: The cut-off values of the maximal and end points of the LE were 0.281 to 0.916 sec, and 0.830 to 2.205 sec, respectively. The cut-off values of the start, maximal and end points of the HE were −0.233 to 0.400 sec, 0.320 to 0.874 sec, and 0.889 to 2.055 sec, respectively. The cut-off values of the start, maximal, and end points of the EF were 0.017 to 0.483 sec, 0.364 to 1.055 sec, and 0.774 to 1.773 sec, respectively. The cut-off values of the duration of LE, HE, and EF were 0.281 to 0.916 sec, 0.258 to 0.767 sec, and 0.255 to 0.787 sec, respectively. CONCLUSION: This study presented the normal cut-off values of temporal variables of hyolaryngeal movements during normal swallowing. This study can serve as a basis for classifying and analyzing the patterns of patients with dysphagia.
Barium ; Deglutition Disorders ; Deglutition* ; Epiglottis ; Healthy Volunteers ; Humans ; Hyoid Bone ; Male ; Vocal Cords

OBJECTIVE: To investigate the influence of a nasogastric tube (NGT) on swallowing simulated saliva in stroke patients. METHODS: Three groups of participants were enrolled into the study: group A (20 stroke patients with a NGT), a control group B (25 stroke patients without a NGT), and group C (25 healthy adults with no brain lesions or dysphagia). Participants swallowed 1 mL of water to simulate saliva. Patients in group A were tested twice: once with a NGT (group A1) and once after the NGT was removed (group A2). The distance of hyoid bone movement was measured by subtracting the shortest distance between the mandible and hyoid bone (S) from the distance at resting state (R) measured with ultrasonography. The degree of the movement was calculated by (R–S)/R. The trajectory area of hyoid bone movement (Area) and the interval between the beginning of hyoid bone movement and the moment of the shortest hyoid−mandible approximation (Interval) was calculated by a computer program. RESULTS: From group A: R–S and (R–S)/R of group A2 at 1.14±0.36 cm and 0.30±0.09 cm and were significantly greater than those of group A1 at 0.81±0.36 cm and 0.22±0.08 cm (p=0.009 and p=0.005). After removing the NGT as seen in group A2, R–S and (R–S)/R were improved to the level of those of group B at 1.20±0.32 cm and 0.30±0.09 cm (p=0.909 and p=0.997). The Area of group A2 was larger and the Interval of group A2 was shorter than those of group A1 though a comparison of these factors between A2 and A1 did not show a statistically significant difference. CONCLUSION: A NGT interferes with the movement of the hyoid bone when swallowing 1 mL of water in stroke patients though the movement is restored to normal after removing the NGT.
Adult ; Brain ; Deglutition Disorders ; Deglutition* ; Humans ; Hyoid Bone* ; Mandible ; Saliva ; Stroke* ; Ultrasonography* ; Water